Introduction: Heterotopic pregnancy is defined as a spontaneous intrauterine and ectopic pregnancy. The incidence of this type of pregnancy is estimated at 1 in 30,000 in the general population. This Pregnancy is commonly seen in the use of vitro fertilization and ovarian induction. It is a life-threatening disease. It may be ignored in diagnostic procedures; therefore, this can change into a diagnostic and therapeutic problem for physicians. In this study, we report a case of heterotopic pregnancy in a 37-year-old woman who was undergone laparotomy and
curettage.Description: A 37-year-old woman presented with a history of two times cesarean section surgery and an ectopic pregnancy that has been self-absorbed in the last 6 months. The patient has been referred to physician because of the delay in menstruation since 3 last weeks. Considering the ultrasonography that has been done for the patient, a picture of gestational sac with a normal shape and position, normal and uniformly decidual reaction containing yolk sac without embryo in the uterine cavity with free fluid in the pelvic cavity indicated the heterotopic pregnancy. The gestational age was estimated based on MSD of 5w+5d. The patient has been undergone laparotomy surgery. The ovary and right fallopian have been removed and
curettage has been done.Conclusion: Heterotopic pregnancy can occur in normal cycles and in the absence of any predisposing risk factors. Therefore, pregnant women should consider the possibility of heterotopic pregnancy as the diagnosis of intrauterine pregnancy cannot rule out the possibility
of concomitant ectopic pregnancy.